Effects of Education and Counseling on Adherence to Antiretroviral Therapy in HIV Clinic at Mahasarakham Hospital

The objectives of this study were to assess the effects of education and counseling on adherence to antiretroviral therapy and determine factors associated with adherence in the HIV clinic at Mahasarakham hospital. A quasi-experimental design, to compare knowledge and adherence to antiretroviral therapy between an experimental (received education and counseling) and control group (not received education and counseling), two times follow up every month. Fifty-six patients with HIV were recruited: 28 patients were experimental group and 28 patients were control group. The patients’ knowledge in AIDS and antiretroviral drug were significantly increased (p \< 0.001) after education. The adherence evaluated by questionnaires showed that the adherence in the experimental group statistically significant increased (p=0.02 and 0.001, respectively) but the control group was not different. The adherence to antiretroviral therapy in the experimental group was more significantly increased than control group (p=0.004) after receiving counseling the second time. The adherence was measured by pill count method; neither experimental nor control group had significant effect before and after counseling, and they were not different at the second time of follow up. The self-record of taking medicines method, adherence was not different in both groups. The patients’ knowledge in AIDS and antiretroviral therapy were significantly associated with adherence both before and after educations (p=0.017 and 0.003, respectively). History of drug abuse, drug allergy and number of recalled memory method in taking antiretroviral drugs were significantly associated with adherence (p=0.038, 0.03 and 0.014, respectively). Patient education and counseling about disease and antiretroviral drugs by a pharmacist can improve antiretroviral adherence.

Prevalence of Depression and Counseling Outcomes in a Population of Takonyang, Community, Kantharawichai District, Mahasarakham Province

The severe effect of depression is a suicidal commitment. The pharmacist can play a key role in decreasing depression. The objective of this study was to assess the prevalence and counseling outcomes of depression in population of Takonyang. Patients who had depression were randomized into a study group or a control group. The study was performed during December 2006 to March 2007 at Takonyang. A total of 171 persons were screened in the study. The result found that 31 persons had signs of mood disorder and 4 persons had signs of depression (2.34%). Thirty-four mood disorder or depression patients were randomly assigned into the study group or control group. There were 16 patients and 18 patients in the study group and control group, respectively. Both groups were assessed before and after 2 months of counseling. Baseline characteristics and depression score were not significantly different between the study group and control group (p \> 0.05). After counseling, the depression score in the study group was significantly decreased (3.25±1.73 vs 0.81±2.48, p=0.004). The total depression score of patients in the study group was significantly lower than the control group (0.81±2.48 and 2.33±1.97, p=0.002). The results of this study showed that pharmacist counseling can decrease scores of depression and promoted the right behavior and good mental health of the patients. Pharmacist care in patients with depression should be continuously provided as well as for patients with other chronic diseases.

Effects of Counseling for Stress and Depression in Pharmacy Students at Mahasarakham University

The aims of this study were to evaluate the stress and depression screening scores, and the quality of life in the part of physical and mental health scores after counseling and follow-up between the study group (the counseller was educated) and the control group (regular system). The first to fifth year students in the Faculty of Pharmacy, Mahasarakham University were screened between July 2007-Febuary 2008, using questionnaires from the Mental Health Department, Ministry of Public Health, and the Short Form-12. Students who had stress and/or depression were divided into 2 groups: the study (n=34) and the control (n=57) groups. Most of them were female both in the study group (73.5%) and in the control group (84.5%). The average age was 19.8±1.54 years in the study group and 19.9±1.54 years in the control group. The screening stress and depression scores in both groups were significantly reduced from baseline (p \< 0.05). However, there was no significant difference between two groups. The physical health scores did not improve from baseline in both groups and there was no significant difference between the two groups. The scores of stress were positively related with the scores of depression. The scores of stress and depression were negatively related with the scores of quality of life both in physical and mental parts. This study proposes that the university should arrange an effective counseling system and continue to follow-up the students, establish a mental counseling center and hot-line to help and resolve problems for students.

The Prevalence of Stress and Depression among Pharmacy Students at Mahasarakham University

This study were to investigate the prevalence and precipitating factors of stress and depressed mood in pharmacy students, and to evaluate the stress, and depression screening scores. The first phase of the study was a screening survey. Students in the Faculty of Pharmacy, Mahasarakham University were screened between July 2007 and February 2008, using questionnaires from the Mental Health Department, Ministry of Public Health. Of the 499 questionnaires issued, 430 were completed (86.2%). Most respondents were female (83.0%). The average age was 20.1±1.7 years. The prevalence of stress was 3.0% for intermediate level and 2.8% in high level. The prevalence of depression students was 24.5%. The incidence of suicide thinking was 47.1%. The lecturers proposed that the university should arrange the effective counseling system and continue to follow-up the students.

Outcomes of Pharmaceutical Care in Anticoagulation Clinic at Roi-Et Hospital, Roi-Et Province, Northeastern Thailand

The objectives of this study were to compare before and after pharmaceutical care in patient’s INR, knowledge scores about disease, warfarin treatment and correction of self-management while using warfarin, number and type of warfarin-related problems. Patients who were treated with warfarin and got service in the anticoagulation clinic at Roi-Et Hospital during January 9 to April 12, 2006 were recruited. This study was a before and after experimental study with no control group. Primarily, 60 patients were included but one was excluded because of irregular attendance at treatment follow up. Among 59 patients, 39 were women (66.1%) and 20 were men (33.9%). Their average age was 51.1 ± 10.7 years old. Most patients either before or after pharmaceutical care had INR lower than the target INR (69.5% and 47.5%, respectively). The number of patients who had INR lower than the target INR was significantly decreased than before pharmaceutical care (p \< 0.001). The average knowledge scores about disease, warfarin treatment and correction of self-management while using warfarin before and after pharmaceutical care were 6.58 ± 1.62 and 9.80 ± 1.30, respectively. There was a significant increase in the average score after pharmaceutical care (p \< 0.001). Warfarin-related problems before pharmaceutical care were 70 in 43 patients (72.9%). The most common types of problem were non-compliance (27.2%), subtherapeutic dosage (25.7%), and bleeding (21.4%). After pharmaceutical care, there were 20 problems in 16 patients (27.1%). The type of these problems included subtherapeutic dosage (35.0%), drug-drug interaction (35.0%), and bleeding (30.0%). The number of warfarin-related problems was significantly decreased after pharmaceutical care (p \< 0.001). Therefore, the drug counseling and pharmaceutical care by pharmacists for patient who used medication could help reduce drug-related problems, increase knowledge, understand warfarin therapy and correct self-management that would lead to increase the effectiveness of therapy and patients’ quality of life.